Usefulness of thoracic CT to diagnose tuberculosis disease in patients younger than 4 years of age

Garrido, José Batlles; Hernández, I. Alías; Perales, Antonio Bonillo; Ruiz, T. Rubí; Jimenez, Yomary; Garzón, M. González-Ripoll; Maldonado, JorgeE.; Rojas, Jesús Domínguez; Lirola, Miguel Martínez; Vives, Joaquim

doi:10.1002/ppul.22562

Cited by 18 publications

(24 citation statements)

References 27 publications

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“…A recent study analyzed the usefulness of CT in the diagnosis of TB in a TB outbreak that affected 28 children younger than 4 years in a nursery in Spain [54]. Fourteen of the children had normal chest X-ray but 12 of them (8 without any clinical symptom) presented adenopathies >10 mm or infiltrates on CT.…”

Section: Ct In Children With Tuberculosis Infection and With No Apparmentioning

confidence: 99%

Diagnosis of Pulmonary Tuberculosis in Children

Gomez-Pastrana¹

2013

J. infect. dis. ther

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Children account for a major proportion of the global tuberculosis disease burden, especially in endemic areas. Diagnosis of latent tuberculosis infection relies on immunodiagnostic methods, which include the tuberculin skin test and the Interferon-gamma release assays (IGRAs). IGRAs improve specificity in BCG vaccinated children and have been incorporated in several national guidelines especially in low incidence and high-resource settings. However, careful interpretation of this test should be taken especially in young children. Childhood pulmonary tuberculosis is under diagnosed, in part due to difficulties in obtaining microbiological confirmation. Other specimens include induced sputum and nasopharyngeal aspirated that simplify the sample collection without hospital admission. Nucleic amplification assays have similar sensitivity than culture but the results can be obtained in one day. The recent development of an integrated specimen processing and real-time PCR testing (GeneXpert MTB/ RIF system) allows the identification of Mycobacterium tuberculosis and also can detect rifampicin resistance, although additional confirmatory tests of resistance are recommended. Computed tomography (CT) scan is a useful tool in the symptomatic child with difficult diagnosis.

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Section: Ct In Children With Tuberculosis Infection and With No Apparmentioning

confidence: 99%

Diagnosis of Pulmonary Tuberculosis in Children

Gomez-Pastrana¹

2013

J. infect. dis. ther

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“…These results are similar to those obtained by other authors. [29][30][31][32] Regarding the lymph nodes, the necrotic aspect, with peripheral contrast enhancement and hypodense center, was statistically significant associated with changes in lung parenchyma, bronchial compression, and positive culture. This data support the idea that this type of lymphadenopathy is typical of TD and reflect its activity.…”

Section: Delacourt Et Al 21 Performed Chest Ct In 15 Children With Nomentioning

confidence: 96%

“…This conclusion is the same as Garrido et al observed in their work. 30 Since in these cases there is an increased risk of progression and complications of TD, CT would have on them the clearest indication. Another possibility is chemoprophylaxis in this group with two drugs.…”

Section: Delacourt Et Al 21 Performed Chest Ct In 15 Children With Nomentioning

confidence: 99%

Findings and Utility of Chest Computed Tomography in Pediatric Tuberculosis

Moreno-Ballester

Aparici-Robles

Martí‐Bonmatí

et al. 2017

J Pediatr Infect Dis

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The objectives of this study are to describe the radiologic abnormalities detected on chest computed tomography (CT) of children suffering from tuberculosis and identify in which asymptomatic children, with positive tuberculin skin test and normal chest radiography, CT has the highest diagnostic yield using a low radiation dose protocol. The most common finding on CT in cases of tuberculosis is lymphadenopathy with necrotic appearance. In asymptomatic children with positive tuberculin skin test and normal chest radiography, CT had higher diagnostic yield in children younger than 5 years, modifying the therapeutic approach in a high percentage of cases. Reduction kilovoltage (kV) and milliamperage (mA) protocols significantly decrease the radiation dose, keeping sufficient diagnostic quality.

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“…Hiler veya mediastinal lenf nodu büyümesi TB'li hastaların BT incelemelerinde en sık karşılaşılan bulgudur fakat reaktivasyon TB'de yaygın değildir (28). Bazı yazarlar, patolojik lenf nodlarının 5 ile 10 mm arasında olduğunu diğerleri ise 10 mm'den daha büyük olanların patolojik olduğunu vurgulamıştır (29,30). Bu çalışmada tBT'de 10 mm'den daha büyük lenfadenopatiler patolojik lenf nodu olarak kabul edildi.…”

Section: İstatistiksel Analizunclassified

Çocukluk Çağı Akciğer Tüberkülozu Tanısında Bilgisayarlı Tomografinin Yeri

Kaplan¹,

Akan²,

Dalgıç³

et al. 2019

J Pediatr Inf

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Bu çalışmanın amacı, çocukluk çağı akciğer tüberkülozu tanısında spesifik bilgisayarlı tomografi (BT) bulgularını tanımlamaktır. Gereç ve Yöntemler: Çalışmaya tüberküloz şüphesi olan 57 çocuk hasta dahil edildi. Toraks BT görüntüleri iki radyolog tarafından değerlendirildi. On yedi hasta kültür pozitifliği ile (mide açlık suyu, plevral sıvı, biyopsi veya bronkoalveoler lavaj örnekleri), 20 hasta ise klinik olarak tüberküloz tanısı aldı. Değerlendirilen kriterler lenf nodu büyümesi (> 1 cm), kalsifiye lenf nodları, konsolidasyon, kavitasyon, bronşiyal dallarda belirginleşme, plevral efüzyon, plevral kalınlaşma, ampiyem ve atelektazi olarak belirlendi. Tüberküloz hastaları (grup A) ve tüberküloz olmayan hastalar (grup B) arasındaki farklar Fisher exact testi kullanılarak analiz edildi. Bulgular: Lenf nodu büyümesi (> 1 cm), grup B'ye (5/20) kıyasla grup A'da (27/37) anlamlı olarak daha fazla bulundu (p< 0.01). B grubunda konsolidasyon (11/20), grup A'ya (7/37) kıyasla anlamlı olarak daha sık görüldü (p< 0.01). En büyük çapı > 1 cm olan lenf nodu büyümesinin duyarlılık ve özgüllüğü sırasıyla %73 ve %75 idi. Grup A'daki hastaların %43.2 (n= 16)'sinde plevral efüzyon, %40.5 (n= 15)'inde atelektazi, %18.9 (n= 7)'unda plevral kalınlaşma, %16.2 (n= 6)'sinde bronşiyal dallarda belirginleşme, %18.9 (n= 7)'unda konsolidasyon ve %13.5 (n= 5)'inde kalsifiye lenf nodları mevcuttu. B grubundaki hastaların ise %40 (n= 8)'ında plevral efüzyon, %35 (n= 7)'inde atelektazi, %20 (n= 4)'sinde plevral kalınlaşma, %20 (n= 4)'sinde ampiyem ve %15 (n= 3)'inde bronşiyal dallarda belirginleşme mevcuttu. Bu farklılıklar anlamlı değildi.

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Usefulness of thoracic CT to diagnose tuberculosis disease in patients younger than 4 years of age

Abstract: In children younger than 4-year old with positive TST and normal CXR, it would be advisable to perform a TCT since the findings could change the diagnosis from TBI to TB disease.

Cited by 18 publications

References 27 publications

Diagnosis of Pulmonary Tuberculosis in Children

Diagnosis of Pulmonary Tuberculosis in Children

Findings and Utility of Chest Computed Tomography in Pediatric Tuberculosis

Çocukluk Çağı Akciğer Tüberkülozu Tanısında Bilgisayarlı Tomografinin Yeri

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